Medicare, technology and fraud also rank high in annual assessment.

Dec. 18, 2013 - 06:00AM
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Not surprisingly, oversight of the newly created health insurance exchanges ranks among the Health and Human Services Department’s leading management challenges, the HHS inspector general said in a new rundown released this week.

But so do fighting Medicare fraud and waste, making effective use of technology to protect HHS programs generally from abuse and ensuring that grant and contract dollars are spent properly, the IG said in the annual update.

The exchanges are required by the 2010 Affordable Care Act (often dubbed “Obamacare”) to let consumers buy coverage on marketplaces run by some states and the federal government.

The IG last year flagged implementation of the act as HHS’s leading challenge. With the rollout of healthcare.gov, the web portal for the federal exchange, administrators have to ensure that the site sends accurate information to insurers and manage the host of contractors working on the project, the update says. Although the Obama administration has reported progress since the site’s disastrous October debut, HHS must still wrap up implementation of the financial management systems needed to make accurate payments to insurers, the IG said.

Health and Human Services administrators face similar trials in using technology and data to safeguard program integrity. While the Medicaid program dispenses hundreds of billions of dollars annually, for example, it still lacks the complete and accurate payment database needed to monitor spending, according to the reprt. And while Congress has ordered the department to use predictive analytics to head off improper claims in one part of the Medicare program, the IG found that the resulting fraud prevention system did not meet all reporting requirements and that the estimated savings and recoveries may be inaccurate.